Multisystem Developmental Disorder in Children from 2 to 6 Years Old : A Three Years Follow-Up Study

This research studied children who had been diagnosed with Multisystem Developmental Disorder (MSDD) (NC, 2002) under the Diagnostic Classifications of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0 - 3). They all showed, to a varying degree, difficulties in relating to others, play, affective interaction and severe delay in developing communication skills. Some studies have observed continuity in the diagnosis of autism during the first years of life. The objective of this study is to analyse the development of infants with MSDD whose diagnosis of autism was not confirmed. We also attempted to verify any possible psychomotor developmental differences based on, or related to, the severity and typology (B and C) of the MSDD. To enable us to do this we carried out a 3-year follow-up during which we assessed the infants (n = 15) and their parents. They are 2 - 4 years old. Results showed that type B children did present a greater impairment of psychomotor development in assessment tests. However, we did not observe any correlation between the degree of severity of the initial symptoms and later diagnoses. Conclusion: although our sample is small, we can conclude that there isn’t a clear evolution in the diagnosis, but we have found significant differences in the symptomatology between the type B and C

Least squares regression with errors in both variables: case studies

Analytical curves are normally obtained from discrete data by least squares regression. The least squares regression of data involving significant error in both x and y values should not be implemented by ordinary least squares (OLS). In this work, the use of orthogonal distance regression (ODR) is discussed as an alternative approach in order to take into account the error in the x variable. Four examples are presented to illustrate deviation between the results from both regression methods. The examples studied show that, in some situations, ODR coefficients must substitute for those of OLS, and, in other situations, the difference is not significant.

Understanding Neolithic Southern Levant: case studies of archaeological semiosis in action

I undersökningen tillämpas Charles Sanders Peirces semiotik för en kritisk granskning av arkeologiska tolkningsprocesser. Enligt Peirce bygger all betydelsegivning på tecken, som kan vara teckningar, föremål, ord, byggkonstruktioner eller egentligen vad som helst. Ett tecken är tredimensionellt: ”objekt”, ”tecken” och ”tolkning”. I sina tidiga skrifter definierar han tre grundtyper för tecknet, Index, Icon och Symbol. De grundläggande definitionerna i Peirces semiotik blir till ett slags lins. När den placeras på skrifter av en arkeolog som uttolkar tecken, framträder deras inre uppbyggnad, motiveringar och logiska konsekvens klart. Att beakta är, att denna bok är lika lite avsedd att utgöra en systematisk klarläggning av den arkeologiska semiotiken, som en omfattande beskrivning av symboliken i det neolitiska Mellanöstern. Analysen är deskriptiv och inte avsedd att utvärdera tolkningarnas riktighet, utan enbart att klarlägga hur arkeologen kommit fram till dessa. Som objekt har valts neolitiska södra Levanten, där viktiga fynd gällande denna i mänsklighetens kulturhistoria så betydelsefulla skede har gjorts. Förhistorien är intressant med tanke på arkeologisk semiosis, eftersom uttolkaren av en symbol inte kan stöda sig på textfynd, utan måste på annat sätt upptäcka vad ett föremål eller en byggnad betytt för sin upphovsman. Att upptäcka en trovärdig betydelse är ofta en mycket svår och understundom rentav omöjlig uppgift. Efter att förhållandet mellan semiotik och arkeologi dryftats analyseras i boken John Garstangs och Kathleen M. Kenyons grundläggande tolkningar i Jeriko, Denise-Schmandt Besserats jämförande analyser för uttolkningen av \'Ain Ghazalis kranium, Michele A. Millers kontextuella analys i Jarmuk samt David Lewis-Williams’ starkt strukturalistiska analys av betydelsen av fynden i \'Ain Ghazal. Peirces semiotik har använts som stöd för arkeologin i mycket mindre utsträckning än F. de Saussures lingvistiska ja strukturalistiska semiotik. I Mellanöstern har man hittills inte alls gjort det. Ingen av de forskare som behandlas i boken hänvisar själv till semiotik eller tecken. Logiken i uttolkningen av dessa undersökningar är mycket invecklad, och de av Peirce gestaltade processerna för betydelsegivning visar sig härvidlag utgöra en ytterst klargörande kritisk apparat.

Clinical and pathological challenges in the diagnosis of late-onset biliary atresia: four case studies

Biliary atresia (BA) is classically described at the neonatal age. However, rare cases of BA in older infants have also been reported. We report four cases of late-onset BA in infants older than 4 weeks (3 males, 1 female), and describe the diagnostic and management difficulties. One of the cases had a late-onset (29 weeks) presentation with a successful surgical procedure. We highlight the importance of this unusual differential diagnosis in infants with cholestatic syndrome, who may benefit from Kasai surgery, regardless of age.

Tracing Innovation Practices in Seaports: the Ports of Klaipeda and Stockholm as Case Studies

This study explores variegated means through which ports have become increasingly entangled in the planning logic of neoliberal innovation-driven economy. The research topic belongs to the academic disciplines of economics and human geography. The aim of the thesis is to analyse how the notion of innovation, adopted in a variety of supranational and national port policy documents, is deployed in operational port environment in two different ports of the Baltic Sea Region: the port of Stockholm, Sweden, and the port of Klaipeda, Lithuania. This novel innovation agenda is visible in several topics I examine in the study, that is, port governance, environmental issues, and seaport – port-city interface. The gathered primary source material on port policy documents, strategies, development planning documents and reports is analysed by utilizing the qualitative content analysis research method. Moreover, the empirical part of the case study, that is, tracing innovation practices in mundane port activities is based on collected qualitative semi-structured interviews with port authorities in Klaipeda and Stockholm, researchers and other port experts. I examine the interview material by employing the theoretical reading research method. In my analysis, I have reframed port-related policy development by tracing and identifying the port transformation from “functional terminals” to “engines for growth”. My results show that this novel innovation-oriented rhetoric imprinted in the narrative “engines for growth” is often contested in daily port practices. In other words, my analysis reveals that the port authorities’ and other port actors’ attitudes towards innovations do not necessarily correspond to the new narrative of innovation and do not always “fit” within a framework of neoliberal economic thinking that glorifies the “culture of innovations”. I argue that the ability to develop innovative initiatives in the ports of Klaipeda and Stockholm is strongly predetermined by local conditions, a port’s governance model, the way port actors perceive the importance of innovations per se, demand factors and new regulations.

Post-transaction brand and model line-up integration in the automotive industry: Case studies of European companies as target of acquisitions by Chinese and Indian multinational corporations

Corporations practice company acquisitions in order to create shareholder’s value. During the last few decades, the companies in emerging markets have become active in the acquisition business. During the last decade, large and significant acquisitions have occurred especially in automotive industry. While domestic markets have become too competitive and companies are lacking required capabilities, they seek possibilities to expand into Western markets by attaining valuable assets through acquisitions of developed country corporations. This study discusses the issues and characteristics of these acquisitions through case studies. The purpose of this study was to identify the acquisition motives and strategies for post-transaction brand and product integration as well as analyze the effect of the motives to the integration strategy. The cases chosen for the research were Chinese Geely acquiring Swedish Volvo in 2010 and Indian Tata Motors buying British Jaguar Land Rover in 2008. The main topics were chosen according to their significance for companies in automotive industry as well as those are most visible parts for consumers. The study is based on qualitative case study methods, analyzing secondary data from academic papers and news articles as well as companies’ own announcements e.g. stock exchange and press releases. The study finds that the companies in the cases mainly possessed asset-seeking and market-seeking motives. In addition, the findings refer to rather minimal post-acquisition brand and product integration strategies. Mainly the parent companies left the target company autonomous to make their own business strategies and decisions. The most noticeable integrations were in the product development and production processes. Through restructuring the product architectures, the companies were able to share components and technology between product families and brands, which results in cutting down costs and in increase of profitability and efficiency. In the Geely- Volvo case, the strategy focused more on component sharing and product development know-how, whereas in Tata Motors-Jaguar Land Rover case, the main actions were to cut down costs through component sharing and combine production and distribution networks especially in Asian markets. However, it was evident that in both cases the integration and technology sharing were executed cautiously to prevent on harming the valuable image of the luxury brand. This study has concluded that the asset-seeking motives have significant influence on the posttransaction brand and model line-up integration strategies. By taking a cautious approach in acquiring assets, such as luxury brand, the companies in the cases have implemented a successful post-acquisition strategy and managed to create value for the shareholders at least in short-term. Yritykset harjoittavat yritysostoja luodakseen osakkeenomistajille lisäarvoa. Viimeisten muutamien vuosikymmenien aikana yritykset kehittyvissä maissa ovat myös aktivoituneet yritysostoissa. Viimeisen vuosikymmenen aikana erityisesti autoteollisuudessa on esiintynyt suuria ja merkittäviä yritysostoja. Koska kilpailu kotimaan markkinoilla on kiristynyt ja yritykset ovat vailla vaadittavia valmiuksia, ne etsivät mahdollisuuksiaan laajentaa länsimaisiin markkinoihin hankkimalla arvokkaita etuja kehittyneiden maiden yrityksistä yritysostojen avulla. Tämä tutkimus pohtii näiden yritysostojen olennaisia kysymyksiä ja ominaisuuksia casetutkimuksien kautta. Tutkimuksen tarkoitus oli tunnistaa sekä yritysostojen motiiveja ja brändi- ja mallisto-integraation strategioita että analysoida kyseisten motiivien vaikutusta integraatiostrategiaan. Tapaus-tutkimuksiksi valittiin kiinalaisen Geelyn yritysosto ruotsalaisesta Volvosta vuonna 2010 ja intialaisen Tata Motorsin yritysosto englantilaisesta Jaguar Land Roverista vuonna 2008. Tutkimus on kvalitatiivinen case-tutkimus ja siinä analysoidaan toissijaista tietoa sekä akateemisten ja uutisartikkeleiden että yritysten omien ilmoitusten, kuten pörssi- ja lehdistötiedotteiden, kautta. Tutkimuksen tulokset osoittavat, että tutkittujen yritysten toiminnat perustuivat motiiveihin, joita ajoivat etujen and uusien markkinoiden tarve. Sen lisäksi tutkimustulokset osoittivat, että yritysoston jälkeinen brändi- ja mallisto-integraatio pidettiin minimaalisena. Pääasiallisesti kohdeyrityksille jätettiin autonomia tehdä omat liikkeenjohdolliset päätökset yritysstrategioihin liittyen. Huomattavimmat integraatiot koskivat tuotekehityksellisiä ja tuotannollisia prosesseja. Kehittämällä uudelleen tuotearkkitehtuureja, yritykset pystyivät jakamaan komponentteja ja teknologiaa tuoteperheiden ja brändien välillä. Tämä mahdollisti kustannusleikkauksia sekä kannattavuuden ja tehokkuuden parantamista. Geely-Volvo –tapauksessa integraatiostrategia keskittyi komponenttien jakamiseen yhteisten tuotearkkitehtuurien avulla ja tuotekehityksen ammattitaitoon, kun taas Tata Motors-JLR –tapauksessa päätoiminnat olivat kustannuksien leikkaus sekä tuotannon ja jakeluverkoston yhdistäminen erityisesti Aasian maissa. Yhteistä yrityskaupoissa oli, että brändi- ja mallisto-integraatio sekä teknologian jakaminen suoritettiin varoen ehkäistäkseen arvokkaiden luksus-brändien tuotekuvan vahingoittamista. Tutkimuksen lopputulokset osoittavat, että yrityskaupan motiiveilla on huomattava vaikutus brändija mallisto-integraation strategiaan. Toteuttamalla varovaista lähestymistapaa luksus-brändin hankinnassa ja integraatiossa, yritykset ovat onnistuneet luomaan lisäarvoa osakkeenomistajille vähintään lyhyellä aikavälillä.

The effectiveness of a multisensory writing program in improving cursive writing ability in children with sensorimotor difficulties

It is estimated that five to ten percent of children experience sensory motor difficulties that result in various learnlng disabilitiies , among them. inabllity to output Information on paper in the appropriate manner (Ayres ,1985). The relationship between sensorimotorabillty and handwriting is well documented in the literature (Freeman,1917; Townsend , 1951; Nlkola-Ll sa, 1987). While much of the literature is inconclusive, there are findings to suggest that muitisensory handwriting programmes are an effective approach to improvlng writing abIlity in these chlldren. For a number of years, Occupational Therapists have been involved in the remediation of handwriting utllizing , amongst other approaches . multisensory programmes. While subjective assessments of effectiveness have been extremerly positive. scientIfic evaluation has been minimal . If further intervention in this area is to occur, it Is essential that the profession be able to justify the existence of such programmes . The purpose of this study was to examine what effects a multlsensory writing prog~am would have on the curslve writing ability of chlldren with sensorimotor dlfficulties. A single case with multiple baselines across be havlours design was used , with the behavlours being cursive writing abilIty of fIve distInct letter groups. The fIve groups were taught in random order, one group every two weeks , In a one-hour session. Repeated measurements of writing speed and qualIty for each letter group were made. This design was repeated over three other cases . Results of the study yielded statistical signifi cance in trend changes In specIfic letter groups for all of the chlldren following interventlon. One child achieved statistical significance In the overall change In quality , while none of the children achieved overall statistical significance In speed score changes . Teacher reports and an assessment of written language prior to and following the program suggest that Intervention may have had a positive effect on self-confidence in written output, and on the maturlty of written expression in some of the cases . Further research in this field is needed to validate the continual use of multisensory writing programmes by Occupational Theraplsts worklng with this specific population and to provide some directlon with regards to the Integration of multlsensory writing programmes within the regular academic remedial programme .

An assessment of autism knowledge in the medical field

Once thought to be rare, pervasive developmental disorders (PDDs) are now recognized as the most common neurological disorders affecting children and one of the most common developmental disabilities (DD) in Canada (Autism Society of Canada, 2006). Recent reports indicate that PDDs currently affect 1 in 150 children (Centre for Disease Control and Prevention, 2007). The purpose of this research was to provide an understanding of medical resident and practicing physicians' basic knowledge regarding PDDs. With a population of children with PDDs who present with varying symptoms, the ability for medical professionals to provide general information, diagnosis, appropriate referrals, and medical care can be quite complex. A basic knowledge of the disorder is only a first step in providing adequate medical care to individuals with autism and their families. An updated version of Stone's (1987) Autism survey was administered to medical residents at four medical schools in Canada and currently practicing physicians at three medical schools and one community health network. As well, a group of professionals specializing in the field ofPDDs, participating in research and clinical practice, were surveyed as an 'expert' group to act as a control measure. Expert responses were consistent with current research in the field. General findings indicated few differences in overall knowledge between residents and physicians, with misconceptions evident in areas such as the nature of the disorder, qualitative characteristics of autism, and effective interventions. Results were also examined by specialty and, while pediatricians demonstrated additional accurate 11 knowledge regarding the nature of the disorder and select qualitative impairments, both residents and practicing physicians demonstrated misconceptions about PDDs. This preliminary study replicated the findings of Stone (1987) and Heidgerken (2005) concerning several misconceptions of PDDs held by residents and practicing physicians. Future research should focus on additional replications with validated measures as well as the gathering of qualitative information, in order to inform the medical profession of the need for education in PDDs at training and professional levels.

The role of physical activity and perceived adequacy on cardiorespiratory fitness in children with developmental coordination disorder

Evidence suggests that children with developmental coordination disorder (DCD) have lower levels of cardiorespiratory fitness (CRF) compared to children without the condition. However, these studies were restricted to field-based methods in order to predict V02 peak in the determination of CRF. Such field tests have been criticised for their ability to provide a valid prediction of V02 peak and vulnerability to psychological aspects in children with DCD, such as low perceived adequacy toward physical activity. Moreover, the contribution of physical activity to the variance in V02 peak between the two groups is unknown. The purpose of our study was to determine the mediating role of physical activity and perceived adequacy towards physical activity on V02 peak in children with significant motor impairments. This prospective case-control design involved 122 (age 12-13 years) children with significant motor impairments (n=61) and healthy matched controls (n=61) based on age, gender and school location. Participants had been previously assessed for motor proficiency and classified as a probable DCD (p-DCD) or healthy control using the movement ABC test. V02 peak was measured by a progressive exercise test on a cycle ergometer. Perceived adequacy was measured using a 7 -item subscale from Children's Selfperception of Adequacy and Predilection for Physical Activity scale. Physical activity was monitored for seven days with the Actical® accelerometer. Children with p-DCD had significantly lower V02 peak (48.76±7.2 ml/ffm/min; p:50.05) compared to controls (53.12±8.2 ml/ffm/min), even after correcting for fat free mass. Regression analysis demonstrated that perceived adequacy and physical activity were significant mediators in the relationship between p-DCD and V02 peak. In conclusion, using a stringent laboratory assessment, the results of the current study verify the findings of earlier studies, adding low CRF to the list of health consequences associated with DCD. It seems that when testing for CRF in this population, there is a need to consider the psychological barriers associated with their condition. Moreover, strategies to increase physical activity in children with DCD may result in improvement in their CRF.

Functional analysis and treatment of OCD-related behaviour in a child with Autism Spectrum Disorder

Research indicates that Obsessive-Compulsive Disorder (OCD; DSM-IV-TR, American Psychiatric Association, 2000) is the second most frequent disorder to coincide with Autism Spectrum Disorder (ASD; Leyfer et aI., 2006). Excessive collecting and hoarding are also frequently reported in children with ASD (Berjerot, 2007). Although functional analysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) has successfully identified maintaining variables for repetitive behaviours such as of bizarre vocalizations (e.g., Wilder, Masuda, O'Connor, & Baham, 2001), tics (e.g., Scotti, Schulman, & Hojnacki, 1994), and habit disorders (e.g., Woods & Miltenberger, 1996), extant literature ofOCD and functional analysis methodology is scarce (May et aI., 2008). The current studies utilized functional analysis methodology to identify the types of operant functions associated with the OCD-related hoarding behaviour of a child with ASD and examined the efficacy of function-based intervention. Results supported hypotheses of automatic and socially mediated positive reinforcement. A corresponding function-based treatment plan incorporated antecedent strategies and differential reinforcement (Deitz, 1977; Lindberg, Iwata, Kahng, and DeLeon, 1999; Reynolds, 1961). Reductions in problem behaviour were evidenced through use of a multiple baseline across behaviours design and maintained during two-month follow-up. Decreases in symptom severity were also discerned through subjective measures of treatment effectiveness.

Physical Activity and Fitness in Children with Developmental Disorder

Introduction: Developmental coordination disorder (DCD) is a prevalent condition characterized by poor motor proficiency that interferes with a child‟s activities of daily living. Children with DCD often experience compromised health-related fitness components such as cardiorespiratory fitness (CRF). Purpose: To better understand the physical activity and fitness characteristics of children with probable DCD (pDCD), with a particular focus on CRF. Specifically: (1) to present a synopsis of current literature; (2) to determine the longitudinal trajectories of CRF; (3) to compare the submaximal CRF of children with and without pDCD. Methods: A comprehensive, systematic literature review was conducted of the recent available data on fitness and physical activity and pDCD (Chapter 2). This review provided the background for the other two studies included in this thesis. In Chapter 3, a prospective cohort design was used to assess how CRF in children with pDCD changes over time (56 months) relative to a group of typically developing controls. Using a nested-case control design, 63 subjects with pDCD and 63 matched controls from the larger sample were recruited to participate in the lab-based component of the study (Chapter 4). In this investigation CRF was examined using the oxygen cost of work (VO2) during an incremental test on a cycle ergometer. Results: The literature review showed that fitness parameters, including CRF and physical activity levels, were consistently reduced in children with pDCD. Chapter 3 demonstrated that the difference in CRF between children with pDCD and typically developing children is substantial, and that it tends to increase over time. Results from VO2 assessments showed that children with pDCD utilized more oxygen to sustain the same submaximal workloads compared to typically developing children. Conclusions: Findings from this thesis have made several important contributions to our understanding of children with pDCD. Since differences in CRF between children with and without pDCD tend to worsen over time, this adds to the argument that interventions intended to improve CRF may be appropriate for children with motor difficulties. This thesis also presented the first evidence suggesting that DCD involves higher energy expenditure, and could help explain why children with pDCD perform poorly on tasks requiring CRF.

Unveiling Shi’i Religious Identities: Case Studies of Hijab in Culturally Homogeneous Canadian Schools

This qualitative case study explored 10 young female Shi’i Muslim Arabic-Canadian students’ experiences associated with wearing the Hijab (headscarf) within their home, community, and predominantly White Canadian public elementary school environments. The study integrated several bodies of scholarly theories in order to examine the data under a set of comprehensive lenses that more fully articulates and theorizes on the diversity of female Shi’i Muslim Canadian students’ experiences. These theories are: identity theories with a focus on religious identity and negative stereotypes associated with Muslims; feminism and the Hijab discourses; research pertaining to Muslims in school settings; and critical race theory. In order to readdress the dearth of information about Shi’is’ experiences in schools, this study provides an in-depth case study analysis in which the methodology strategies included 10 semi-structured in-depth interviews, 2 focus-group meetings, and the incorporation of the researcher’s fieldnotes. Data analysis revealed the following themes corresponding to participants’ experiences and values in their social worlds of home, community, and schools: (a) martyrdom and self-sacrifice as a means for social justice; (b) transformational meaning of the Hijab; (c) intersectionality between culture, religion, and gender; and (d) effects of visits “back home” on participants’ religious identities. Additional themes related to participants’ school experiences included: (a) “us versus them” mentality; (b) religious and complex secular dialogues; (c) absence of Muslim representations in monocultural schools; (d) discrimination; (e) remaining silent versus speaking out; and (f) participants’ strategies for preserving their identities. Recommendations are made to integrate Shi’i Muslim females’ identity within the context of Islam and the West, most notably in relation to: (a) the role of Muslim community in nondiverse settings as a space that advances and nurtures Shi’i Muslim identity; and (b) holistic and culturally responsive teaching that fosters respect of others’ religiosity and spirituality. This study makes new inroads into feminist theorizing by drawing conceptual links between these previously unknown connections such as the impact of the historical female exemplary role model and the ritual stories on the experiences of Muslim females wearing the Hijab.

Benefits of Using Target Activities to Assist in Improvement of Striking in Striking and Fielding Games for Individuals with Autism: A Comparative Case Study

The purpose of the research study was to increase understanding about the potential benefits of combining target activities with striking-fielding games for individuals with high functioning autism spectrum disorder. A comparative case study was conducted to understand if target activities can assist in improving the skills of striking and throwing, aid the learning of tactics and add to current understanding of how certain teaching skills might be linked to the transfer between target and striking-fielding games. Data was collected through observations, student journals and interviews and were analyzed using both inductive and deductive methods. Results show an appearance of improvement in throwing, striking, bowling and badminton for overall skill levels. In regards to teaching skills, appropriate and effective teaching techniques, appropriate and effective equipment, dynamic of participants and student-instructors and consistency of attendance are vital. Future research should further look at the transferability to outdoor settings and interview the participants.